Systems and methods for instrument engagement

ABSTRACT

A method of engaging a medical instrument with a medical instrument manipulator comprises receiving an indication that a first input coupling of the medical instrument is positioned adjacent to a first drive output of the manipulator. The first drive output is driven by a first actuating element. In response to receiving the indication, the first drive output is rotated in a first rotational direction. A determination is made, by one or more processors, as to whether a resistance torque is experienced by the first actuating element after rotating the first drive output in the first rotational direction. If the resistance torque is not experienced by the first actuating element after rotating of the first drive output in the first rotational direction, the first drive output is rotated in a second rotational direction. A determination is made, by the one or more processors, as to whether a resistance torque is experienced by the first actuating element after rotating of the first drive output in the second rotational direction.

RELATED APPLICATIONS

This patent application is the U.S. national phase of InternationalApplication No. PCT/US2016/037003, filed Jun. 10, 2016, which designatedthe U.S. and claims priority to and the benefit of the filing date ofU.S. Provisional Patent Application 62/174,204, entitled “SYSTEMS ANDMETHODS FOR INSTRUMENT ENGAGEMENT,” filed Jun. 11, 2015, both of whichis are incorporated by reference herein in its their entiretyentireties.

FIELD

The present disclosure is directed to systems and methods for mechanicalengagement, and more particularly to systems and methods for confirmingthat a drive coupling has successfully engaged with an input coupling.

BACKGROUND

Many mechanical systems make use of motors that move objects intodifferent positions. In general, an actuating element, such as a motor,has a drive output that mates with an input coupling of a tool to beactuated. Various mechanical structures may be used to engage the driveoutput with the input coupling. One example is a boss and pocketstructure. Specifically, the drive output may include a disc that has aboss extending from the surface of the disc. The boss may be designed tofit into a corresponding pocket on a disc connected to the inputcoupling. When the boss is successfully positioned within the pocket,rotation of the drive output causes rotation of the input coupling,which in turn causes movement of the tool.

A mechanical system that involves engaging a drive output with an inputcoupling may be a teleoperative medical system used to perform a medicalprocedure. The teleoperative medical system may include motors withdrive outputs that couple to and operate interchangeable medicalinstruments. In some embodiments, the drive outputs of the motorsinclude drive discs that engage with corresponding instrument discs onthe medical instrument. Each of the instrument discs may actuate adifferent type of motion in the medical instrument. For example, onedisc may control actuating members that change the roll position of theinstrument. Other discs may control actuating members that change theyaw, pitch, or grip of the medical instrument. When an interchangeableinstrument is connected to the teleoperative medical system, each of thedrive discs is engaged with a corresponding instrument disc to drivemovement of the medical instrument as desired.

If the drive outputs are not properly engaged with the input couplings,the medical instrument may not respond correctly to user commandstransmitted through the teleoperative medical system. An impropercoupling may require removal and reattachment of the medical instrumentto the drive outputs, creating inefficiencies in the medical procedure.

SUMMARY

The embodiments of the invention are summarized by the claims thatfollow below.

In one embodiment, a method of engaging a medical instrument with amedical instrument manipulator comprises receiving an indication that afirst input coupling of the medical instrument is positioned adjacent toa first drive output of the manipulator. The first drive output isdriven by a first actuating element. In response to receiving theindication, the first drive output is rotated in a first rotationaldirection. A determination is made, by one or more processors, as towhether a resistance torque is experienced by the first actuatingelement after rotating the first drive output in the first rotationaldirection. If the resistance torque is not experienced by the firstactuating element after the rotating of the first drive output in thefirst rotational direction, the first drive output is rotated in asecond rotational direction. A determination is made, by the one or moreprocessors, as to whether a resistance torque is experienced by thefirst actuating element after the rotating of the first drive output inthe second rotational direction.

In another embodiment, a computer-assisted medical device comprises oneor more processors, a medical instrument manipulator, and a medicalinstrument. The computer-assisted medical device is configured to engagethe medical instrument with the medical instrument manipulator byreceiving an indication that a first input coupling of the medicalinstrument is positioned adjacent to a first drive output of themanipulator. The first drive output is driven by a first actuatingelement. In response to receiving the indication, the first drive outputis rotated in a first rotational direction. A determination is made, byone or more processors, as to whether a resistance torque is experiencedby the first actuating element after rotating the first drive output inthe first rotational direction. If the resistance torque is notexperienced by the first actuating element after the rotating of thefirst drive output in the first rotational direction, the first driveoutput is rotated in a second rotational direction. A determination ismade, by the one or more processors, as to whether a resistance torqueis experienced by the first actuating element after the rotating of thefirst drive output in the second rotational direction.

In another embodiment, a non-transitory machine-readable mediumcomprises a plurality of machine-readable instructions which whenexecuted by one or more processors associated with a computer-assistedmedical device are adapted to cause the one or more processors toperform a method. The method comprises rotating, in a first rotationaldirection, a first drive output of a manipulator portion of thecomputer-assisted medical device. The first drive output being driven bya first actuating element. The method further includes determiningwhether a resistance torque is experienced by the first actuatingelement after rotating the first drive output in the first rotationaldirection. The resistance torque signals an engagement of a first inputcoupling of a medical instrument with the first drive output. The methodfurther includes rotating the first drive output in a second rotationaldirection on the condition that the resistance torque is not experiencedby the first actuating element after the rotation of the first driveoutput in the first rotational direction. The method further includesdetermining whether a resistance torque is experienced by the firstactuating element after the rotation of the first drive output in thesecond rotational direction, wherein the resistance torque signals anengagement of the first input coupling of a medical instrument with thefirst drive output.

In another embodiment, a method of engaging a medical instrument with amedical instrument manipulator comprises receiving an indication that afirst input coupling of the medical instrument is positioned adjacent toa first drive output of the manipulator. The first drive output isdriven by a first actuating element. In response to receiving theindication, rotating the first drive output in a first rotationaldirection according to a preprogrammed rotation protocol. The methodfurther includes determining, by one or more processors, whether aresistance torque is experienced by the first actuating element afterrotating the first drive output in the first rotational directionaccording to a preprogrammed rotation protocol. The method furtherincludes terminating the preprogrammed rotation protocol on thecondition that the resistance torque is experienced by the firstactuating element.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory innature and are intended to provide an understanding of the presentdisclosure without limiting the scope of the present disclosure. In thatregard, additional aspects, features, and advantages of the presentdisclosure will be apparent to one skilled in the art from the followingdetailed description.

BRIEF DESCRIPTIONS OF THE DRAWINGS

Aspects of the present disclosure are best understood from the followingdetailed description when read with the accompanying figures. It isemphasized that, in accordance with the standard practice in theindustry, various features are not drawn to scale. In fact, thedimensions of the various features may be arbitrarily increased orreduced for clarity of discussion. In addition, the present disclosuremay repeat reference numerals and/or letters in the various examples.This repetition is for the purpose of simplicity and clarity and doesnot in itself dictate a relationship between the various embodimentsand/or configurations discussed.

FIG. 1 is a plan view of a minimally invasive teleoperative medicalsystem being used to perform a surgery, in accordance with manyembodiments.

FIG. 2 is a perspective view of a surgeon's control console for ateleoperative medical system, in accordance with many embodiments.

FIG. 3 illustrates the instrument of FIG. 2 in greater detail.

FIGS. 4A and 4B are partially exploded views of a surgical instrumentcoupling portion, an instrument sterile adaptor, and a portion of acarriage of an instrument manipulator.

FIG. 5 is a flowchart showing an illustrative method for instrumentengagement, according to one example of principles described herein.

FIG. 6 is a flowchart showing an illustrative method for instrumentengagement, according to one example of principles described herein.

FIG. 7 is a flowchart showing an illustrative method for instrumentengagement, according to one example of principles described herein.

DETAILED DESCRIPTION

For the purposes of promoting an understanding of the principles of thepresent disclosure, reference will now be made to the embodimentsillustrated in the drawings, and specific language will be used todescribe the same. It will nevertheless be understood that no limitationof the scope of the disclosure is intended. In the following detaileddescription of the aspects of the invention, numerous specific detailsare set forth in order to provide a thorough understanding of thedisclosed embodiments. However, it will be obvious to one skilled in theart that the embodiments of this disclosure may be practiced withoutthese specific details. In other instances well known methods,procedures, components, and circuits have not been described in detailso as not to unnecessarily obscure aspects of the embodiments of theinvention.

Any alterations and further modifications to the described devices,instruments, methods, and any further application of the principles ofthe present disclosure are fully contemplated as would normally occur toone skilled in the art to which the disclosure relates. In particular,it is fully contemplated that the features, components, and/or stepsdescribed with respect to one embodiment may be combined with thefeatures, components, and/or steps described with respect to otherembodiments of the present disclosure. In addition, dimensions providedherein are for specific examples and it is contemplated that differentsizes, dimensions, and/or ratios may be utilized to implement theconcepts of the present disclosure. To avoid needless descriptiverepetition, one or more components or actions described in accordancewith one illustrative embodiment can be used or omitted as applicablefrom other illustrative embodiments. For the sake of brevity, thenumerous iterations of these combinations will not be describedseparately. For simplicity, in some instances the same reference numbersare used throughout the drawings to refer to the same or like parts.

Referring to FIGS. 1 and 2 of the drawings, a teleoperational medicalsystem for use in, for example, medical procedures including diagnostic,therapeutic, or surgical procedures, is generally indicated by thereference numeral 10. As will be described, the teleoperational medicalsystems of this disclosure are under the teleoperational control of asurgeon. In alternative embodiments, a teleoperational medical systemmay be under the partial control of a computer programmed to perform theprocedure or sub-procedure. In still other alternative embodiments, afully automated medical system, under the full control of a computerprogrammed to perform the procedure or sub-procedure, may be used toperform procedures or sub-procedures. As shown in FIG. 1, theteleoperational medical system 10 generally includes a teleoperationalassembly 12 mounted to or near an operating table O on which a patient Pis positioned. The teleoperational assembly 12 may be referred to as apatient side cart. A medical instrument system 14 and an endoscopicimaging system 15 are operably coupled to the teleoperational assembly12. An operator input system 16 allows a surgeon or other type ofclinician S to view images of or representing the surgical site and tocontrol the operation of the medical instrument system 14 and/or theendoscopic imaging system 15.

The operator input system 16 may be located at a surgeon's console,which is usually located in the same room as operating table O. Itshould be understood, however, that the surgeon S can be located in adifferent room or a completely different building from the patient P.Operator input system 16 generally includes one or more controldevice(s) for controlling the medical instrument system 14. The controldevice(s) may include one or more of any number of a variety of inputdevices, such as hand grips, joysticks, trackballs, data gloves,trigger-guns, hand-operated controllers, voice recognition devices,touch screens, body motion or presence sensors, and the like. In someembodiments, the control device(s) will be provided with the samedegrees of freedom as the medical instruments of the teleoperationalassembly to provide the surgeon with telepresence, the perception thatthe control device(s) are integral with the instruments so that thesurgeon has a strong sense of directly controlling instruments as ifpresent at the surgical site. In other embodiments, the controldevice(s) may have more or fewer degrees of freedom than the associatedmedical instruments and still provide the surgeon with telepresence. Insome embodiments, the control device(s) are manual input devices whichmove with six degrees of freedom, and which may also include anactuatable handle for actuating instruments (for example, for closinggrasping jaws, applying an electrical potential to an electrode,delivering a medicinal treatment, and the like). An electronics cart 18can be used to process the images of the surgical site for subsequentdisplay to the surgeon S through the surgeon's console 16.

The teleoperational medical system 10 also includes a control system 20.The control system 20 includes at least one memory and at least oneprocessor (not shown), and typically a plurality of processors, foreffecting control between the medical instrument system 14, the operatorinput system 16, and an electronics system 18. The control system 20also includes programmed instructions (e.g., a computer-readable mediumstoring the instructions) to implement some or all of the methodsdescribed in accordance with aspects disclosed herein. While controlsystem 20 is shown as a single block in the simplified schematic of FIG.1A, the system may include two or more data processing circuits with oneportion of the processing optionally being performed on or adjacent theteleoperational assembly 12, another portion of the processing beingperformed at the operator input system 16, and the like. Any of a widevariety of centralized or distributed data processing architectures maybe employed. Similarly, the programmed instructions may be implementedas a number of separate programs or subroutines, or they may beintegrated into a number of other aspects of the teleoperational systemsdescribed herein. In one embodiment, control system 20 supports wirelesscommunication protocols such as Bluetooth, IrDA, HomeRF, IEEE 802.11,DECT, and Wireless Telemetry.

In some embodiments, control system 20 may include one or more servocontrollers that receive force and/or torque feedback from the medicalinstrument system 14. Responsive to the feedback, the servo controllerstransmit signals to the operator input system 16. The servocontroller(s) may also transmit signals instructing teleoperationalassembly 12 to move the medical instrument system(s) 14 and/orendoscopic imaging system 15 which extend into an internal surgical sitewithin the patient body via openings in the body. Any suitableconventional or specialized servo controller may be used. A servocontroller may be separate from, or integrated with, teleoperationalassembly 12. In some embodiments, the servo controller andteleoperational assembly are provided as part of a teleoperational armcart positioned adjacent to the patient's body.

The teleoperational medical system 10 may further include optionaloperation and support systems (not shown) such as illumination systems,steering control systems, irrigation systems, and/or suction systems. Inalternative embodiments, the teleoperational system may include morethan one teleoperational assembly and/or more than one operator inputsystem. The exact number of manipulator assemblies will depend on thesurgical procedure and the space constraints within the operating room,among other factors. The operator input systems may be collocated orthey may be positioned in separate locations. Multiple operator inputsystems allow more than one operator to control one or more manipulatorassemblies in various combinations.

The teleoperational assembly 12 supports and manipulates the medicalinstrument systems 14 while the surgeon S views the surgical sitethrough the console 16. An image of the surgical site can be obtained bythe endoscopic imaging system 15, such as a stereoscopic endoscope,which can be manipulated by the teleoperational assembly 12 to orientthe endoscope 15. The number of medical instrument systems 14 used atone time will generally depend on the diagnostic or surgical procedureand the space constraints within the operating room among other factors.The teleoperational assembly 12 may include a kinematic structure of oneor more non-servo controlled links 24 (e.g., one or more links that maybe manually positioned and locked in place, generally referred to as aset-up structure) and a teleoperational manipulator 26. An instrumentcarriage 30 travels linearly along an instrument spar 32. As shown alsoin FIG. 3, the medical instrument system 14 includes an instrument shaft34, a surgical tool 36, and a proximal control portion 38. Theinstrument shaft 34 and the surgical tool 36 are controlled by a jointedwrist 40 that allows the orientation of the surgical tool 36 to bemanipulated with reference to the shaft 34. The surgical tool 36 may beany of a variety of surgical tools including forceps, a needle driver, acautery device, a cutting tool, an imaging tool (e.g., an ultrasoundprobe), or a combined device that includes a combination of two or morevarious tools and imaging devices. The surgical tool may include onepiece devices such as cutting instruments or may include two or othermulti-piece devices such as scissors or gripping tools. Surgicalinstruments that are used with the invention may control their surgicaltools with a plurality of rods and/or flexible actuating cablesextending within the shaft 34 and be able to bend as they pass throughthe wrist joint 40. A cannula 42 is coupled to a distal end of theinstrument spar 32 and is sized to receive the shaft 34.

In order to provide a sterile operation area while using a teleoperatedsurgical system, a barrier may be placed between the non-sterile systemand the sterile surgical field. Therefore, a sterile component 44, suchas an instrument sterile adapter (ISA), is placed between the surgicalinstrument 14 and the instrument carriage 30. The placement of aninstrument sterile adapter between the surgical instrument 14 and thecarriage 30 provides a sterile coupling point for the surgicalinstrument 14 and the carriage 30. This permits removal of surgicalinstruments from the carriage 30 and exchange with other surgicalinstruments during the course of a surgery.

FIG. 4A shows a partially exploded view of the coupling of a carriage100 (e.g. carriage 30), an ISA 102 (e.g., ISA 44), and an instrumentproximal control portion 104 (e.g., proximal control portion 38). In oneembodiment, as shown in FIG. 4B, the first stage of the coupling processincludes the ISA 102 coupling with the carriage 100. Carriage driveoutputs, which in this embodiment are drive discs 106 a-e, on thecarriage 100 are rotated to engage the corresponding ISA outputcouplings 108 a-e, respectively. The ISA output couplings, which in thisembodiment are ISA discs 108 a-e, are rotated by the drive discs 106a-e, respectively, to engage corresponding instrument input couplings110 a-e of the instrument proximal control portion 104. In thisembodiment, the instrument input couplings are instrument discs 110 a-e.The instrument carriage 100 houses actuating elements (e.g., motors) fordriving movement of each carriage drive disc 106 a-e. The ISA and ISAcoupling to the carriage is described in detail in U.S. Pat. App. No.62/103,991 filed Jan. 15, 2015 (disclosing “Coupler to Transfer Motionto Surgical Instrument from Teleoperated Actuator”), which isincorporated by reference herein in its entirety. The carriage driveoutputs are described in detail in U.S. Pat. App. No. 61/954,408 filedMar. 17, 2014) (disclosing “Systems and Methods for Confirming DiscEngagement”), which is incorporated by reference herein in its entirety.

In this embodiment, the instrument input couplings 110 a-e aredisc-shaped and each includes a pair of pockets 120 a, 120 b,respectively. In this embodiment, the pockets 120 a, 120 b are locatedat 180 degrees from each other. In alternative embodiments, there may befewer or more pockets arranged with various other spacings. Each of theISA output couplings 108 a-e are disc-shaped and each includes a pair ofbosses 122 a, 122 b. In this embodiment, the bosses 122 a, 122 b may bepositioned near the circumference of the discs, at 180 degrees from eachother. Each boss is sized and shaped to seat within a correspondingpocket. For example, the bosses 122 a, 122 b on the ISA disc 108 e aresized and shaped to seat within the pockets 120 a, 120 b, respectively,of the instrument disc 110 e. In alternative embodiments, there may befewer or more bosses arranged with various other spacings. In variousother embodiments, a sterile adaptor may be omitted and the instrumentdrivers may be directly coupled to the carriage drivers. In variousother embodiments, the boss and pocket configuration may be switchedwith the boss protruding from the instrument disc and with a pocket inthe ISA disc.

In the embodiment of FIGS. 4A and 4B, the ISA includes five discs. Theinstrument may be designed to use any number of the ISA discs to controlmotion of the instrument. For example, one instrument may use only threeof the discs to control operation of the instrument. Another instrumentmay use all five discs. The different ISA discs may be used to drivedifferent types of movement of the instrument. For example, the disc 108d may be used to control the roll of the instrument about theinstrument's axis. The disc 108 c (alone or in combination with otherdiscs) may be used to control the pitch of the surgical tool by movementof the wrist. A coordinated motion of the discs 108 a, 108 b, 108 e maybe used to control the yaw of the wrist and surgical tool. A differentcoordinated motion of the disc 108 a and the disc 108 b may be used tocontrol grip of the instrument. Each of these discs can be checked forproper engagement using the principles described above.

For the teleoperational assembly to control operation of an instrument,the instrument proximal control portion 104 is attached to the ISA 102,thus placing the set of ISA coupling discs 108 a-e adjacent to theinstrument driver discs 110 a-e, respectively. When the discs 108 a-eare first placed adjacent to the instrument discs 110 a-e, the discs maynot be aligned to the proper rotational positions such that the bosseswill slide into the pockets. To achieve full engagement between thebosses and their respective pockets, an instrument engagement proceduremay be conducted.

Full engagement between the bosses and the pockets for each disccoupling allows the medical instrument to operate with a full range ofmotion. In existing systems, engagement procedures may haveinefficiencies. For example, in existing systems the actuating elementcoupled to each drive disc may be programmed to cause the ISA disc torotate for multiple single direction revolutions (e.g. 2 or 3preprogrammed single direction revolutions) until both bosses slide intothe corresponding pockets of the instrument drive disc, thus completingthe engagement. Requiring multiple preprogrammed single directionrevolutions for multiple disc engagements, performed in serial, may beinefficient and time consuming. Existing systems may have no ability tosense engagement and abort the preprogrammed single direction revolutionengagement protocol if engagement is determined prior to the completionof the protocol. In existing systems, rotating the ISA disc for thepreprogrammed multiple single direction revolutions, may still notachieve engagement. If engagement is not achieved, the operator mustdetach the instrument from the ISA, reattach the instrument to the ISA,and initiate the engagement procedure from the beginning. Repeating theengagement procedure may be time-consuming and burdensome to theoperator. Investigations have shown that at least one cause ofengagement failures in existing systems is constraint of the ISA discs.The ISA disc, when coupled to the carriage drive discs, is stronglyconstrained. That is, the spatial orientation of the ISA disc, which mayfunction as an Oldham-style coupling, is generally limited a singletranslational degree of freedom, unable to tilt or translate in multipledimensions. Because of this constraint, slight design variations (e.g.bosses of slightly different lengths or slight instrument tilt) maycontribute to engagement failures. More specifically, a slightmisalignment between the ISA disc and the instrument disc will cause theISA bosses to arrive at the instrument pockets at slightly differenttimes. If the bosses are of slightly different lengths or if theinstrument is tilted, the first boss to reach a first pocket may notactually contact the instrument disc and fall into the first pocket.Rather, it may move just past the first pocket. When the second bossreaches the second pocket and begins to fall in to the second pocket,contact of the second boss with the second pocket may nudge theinstrument disc in its translational degree of freedom, causing thefirst pocket to move further away from the first boss. Thus, the firstboss is unable to drop into the first pocket of the instrument disc asthe ISA disc continues to rotate in the first rotational direction.

The various engagement procedures that follow may minimize or eliminatethe inefficiencies associated with the engagement procedures forexisting systems. These engagement procedures may allow disc engagementto be detected earlier than in existing procedures, thus shavingcritical time from the engagement process. These procedures allow theISA disc to rotate in an opposite direction from the initial directionof rotation, if engagement is not detected on the initial direction ofrotation. Reversing the direction of the rotation may help alleviate theproblem of ISA disc constraint because reverse movement of one engagedboss will nudge the instrument disc, causing the unoccupied pocket tomove toward the second ISA boss. An engagement procedure that providesrotation in both directions may decrease the failure rate and requirefewer reinstallations by the user.

FIG. 5 is a flowchart 200 showing an illustrative method for instrumentengagement. The instrument engagement procedure is initiated after theproximal control portion of the instrument is attached to the ISA andthe ISA discs are placed adjacent to the instrument discs. The controlsystem may receive a signal or other indication that this attachment hasoccurred. In this embodiment, the instrument to be engaged may be anywristed instrument that has a gripping function. For example, thisengagement procedure may be suitable for use with a needle driver (e.g.a large needle driver (LND)), forceps, a shears, a bipolar cauterizer,or a tissue stabilizer or retractor.

At a process 201, a first ISA disc is rotated in a first rotationaldirection. In this embodiment, the first ISA disc may be the disc 108 dassociated with the control of roll motion for the instrument shaft. Inalternative embodiments, ISA discs for controlling other operationaldegrees of freedom of the instrument may be engaged first in theinstrument engagement procedure. In alternative embodiments, the ISA maybe omitted and the carriage drive discs may directly engage theinstrument discs using the described engagement procedures. Duringprocess 201, as the roll ISA disc is rotated in the first rotationaldirection, the other ISA discs (e.g., those controlling yaw, pitch, andgrip) are unengaged. They may, for example, be outside the instrumentdisc range of motion and/or movable to a preparation position outsidethe instrument disc range of motion.

At a process 202, the control system may determine or sense if thebosses of the roll ISA disc have fully engaged the pockets of theinstrument disc while the ISA disc is moving in the first rotationaldirection. More specifically, the control system may determine if theactuating element driving rotation of the ISA disc has experienced aresistance torque (e.g., a stall) due to the instrument discencountering a hard stop, which is a physical limitation that preventsthe engaged instrument and ISA discs from continued rotation. Each motordriving rotation of the ISA disc may have a unique torque threshold. Ahard stop is indicated if the absolute value of the measured resistancetorque is greater than the torque threshold for the specific motor.Encountering a hard stop is an indication that both bosses of the ISAhave engaged the pockets of the instrument discs. Specific examples ofthe structures that may provide hard stops are described in U.S. Pat.App. No. 61/954,408 which was incorporated by reference above. Forexample, the instrument disc may include a protrusion. A protrudingstopping mechanism along the rotational travel path of the protrusionmay provide a physical limitation or hard stop when the protrusion isrotated into abutment with the stopping mechanism. In alternativeembodiments, engagement of the instrument disc and ISA disc may bedetermined by other types of sensors such as optical sensors.

The actuator driving the first ISA disc may be preprogrammed to rotatethe first ISA disc for a preprogrammed number of rotations in the firstdirection, according to a preprogrammed protocol. However, if the hardstop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the firstdirection, the preprogrammed rotation in the first direction is abortedand the engagement procedure proceeds to process 210. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

At a process 204, if engagement of the roll ISA disc is not detected,the ISA roll disc is rotated in second rotational direction, oppositethe first direction. For example, if the first rotational direction isclockwise, the second rotation direction is counter clockwise. At aprocess 206, the control system determines if the bosses of the roll ISAdisc have fully engaged the pockets of the instrument disc while the ISAdisc is moving in the second rotational direction. More specifically,the control system may determine if the actuating element drivingrotation of the ISA disc has experienced a resistance torque (e.g., astall) due to instrument disc encountering a hard stop. Encountering ahard stop is an indication that both bosses of the ISA disc have engagedthe pockets of the instrument discs.

The actuator driving the first ISA disc may be preprogrammed to rotatethe first ISA disc for a preprogrammed number of rotations in the secondrotational direction, according to a preprogrammed protocol. However, ifthe hard stop is encountered (i.e., engagement is determined) prior tothe completion of the preprogrammed number of rotations in the seconddirection, the preprogrammed rotation in the second direction is abortedand the engagement procedure proceeds to process 210. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

If the ISA roll disc has not engaged the instrument disc after rotationin both the first rotational direction and the second rotationaldirection, the process 201 may again be initiated. Optionally, at aprocess 208, the control system may count and limit the number of timesthe processes 201-206 may be repeated. After the count reaches thelimit, the control system may provide the user an indication of failureto engage. If the user receives an indication that the instrument hasfailed to engage, the instrument may be detached from the ISA andreattached to begin the process 200 again.

After processes 202 and 206, if engagement is determined, engagement ofone or more of the remaining ISA discs may be initiated. In thisembodiment, at a process 210, multiple ISA discs are rotated in a firstrotational direction. In this embodiment, the ISA discs rotated atprocess 210 may be the discs 108 a, 108 b, 108 d, 108 e associated withthe control of yaw, pitch, and grip motions for the instrument wrist andsurgical tool.

At a process 212, the control system may determine if the bosses for theyaw, pitch and grip ISA discs have fully engaged the pockets of theinstrument discs while the ISA discs are moving in the first rotationaldirection. More specifically, the control system may determine if theactuating elements driving rotation of the ISA discs for yaw, pitch, andgrip have experienced a resistance torque (e.g., a stall) due toinstrument disc encountering a hard stop. Encountering a hard stop is anindication that both bosses of each ISA disc have engaged the pockets ofthe instrument discs.

The actuators driving the yaw, pitch and grip ISA discs may bepreprogrammed to rotate the discs for a preprogrammed number ofrotations in the first rotational direction, according to apreprogrammed protocol. However, if hard stops are encountered (i.e.,engagement is determined) prior to the completion of the preprogrammednumber of rotations in the first direction, the preprogrammed rotationin the first direction is aborted and the engagement procedure proceedsto process 220. Terminating the preprogrammed movement upon detection ofengagement, may speed the overall engagement process.

At a process 214, if engagement of one or more of the ISA discs is notdetected, the ISA disc(s) for which engagement is not detected isrotated in a second rotational direction, opposite the first direction.For example, if the first rotational direction is clockwise, the secondrotation direction is counter clockwise. The ISA discs that are detectedto be engaged at process 212 will not be rotated in the secondrotational direction. They will generally be held still or moved only tocompensate for the movement of the instrument caused by the discs thatare continuing the engagement process. At a process 216, the controlsystem determines if the bosses of the yaw, pitch, and grip ISA discshave fully engaged the pockets of the instrument discs while the ISAdisc is moving in the second rotational direction. More specifically,the control system may determine if the actuating element drivingrotation of the ISA disc has experienced a resistance torque (e.g., astall) due to instrument disc encountering a hard stop. Encountering ahard stop is an indication that both bosses of the ISA have engaged thepockets of the instrument discs.

The actuators driving the yaw, pitch and grip ISA discs may bepreprogrammed to rotate the discs for a preprogrammed number ofrotations in the second rotational direction, according to apreprogrammed protocol. However, if hard stops are encountered (i.e.,engagement is determined) prior to the completion of the preprogrammednumber of rotations in the second direction, the preprogrammed rotationin the second direction is aborted and the engagement procedure proceedsto process 220. Terminating the preprogrammed movement upon detection ofengagement, may speed the overall engagement process.

If the ISA discs have not engaged the instrument disc after rotation inboth the first rotational direction and the second rotational direction,the process 210 may again be initiated. Optionally, the control systemmay count and limit the number of times the processes 210-216 may berepeated. After the count reaches the limit, the control system mayprovide the user an indication of failure to engage. If the userreceives an indication that the instrument has failed to engage, theinstrument may be detached from the ISA and reattached to begin theprocess 200 again.

In alternative embodiments, rather than performing parallel processesfor engagement of the yaw, pitch, and grip discs, the engagement processfor each disc may be performed in serial (e.g., similar to the processes201-206 where only one disc is engaged at a time). In alternativeembodiments, if multiple disc engagement procedures are performed inparallel (as in processes 210-216), the discs may have differing firstrotational direction and differing second rotational directions. Forexample, the one of the discs associated with yaw, pitch, and gripmovement may have a first clockwise rotational direction and a secondcounter clockwise direction, while another one of the discs associatedwith yaw, pitch, and grip movement may have a first counterclockwiserotational direction and a second clockwise rotational direction.

After processes 212 and 216, if engagement is determined, the successfuland complete engagement of the instrument with the ISA may be confirmedand communicated to a user. After a successful engagement is confirmed,the instrument may be moved to an introductory position to begin themedical procedure. Further, the distal end of the instrument may beprevented from moving beyond the end of the cannula until aftersuccessful engagement is determined.

FIG. 6 is a flowchart 300 showing another illustrative method forinstrument engagement. The instrument engagement procedure is initiatedafter the proximal control portion of the instrument is attached to theISA and the ISA discs are placed adjacent to the instrument discs. Inthis embodiment, the instrument to be engaged may be a staplerinstrument, including for example the stapler instrument described inInternational App. No. PCT/US15/23636, filed Mar. 31, 2015) (disclosing“Surgical Instrument with Shiftable Transmission”), which isincorporated by reference herein in its entirety. The stapler instrumentmay include multiple instrument coupling discs (e.g., discs 110) drivenby multiple carriage/ISA discs. For example, instrument discs for wristmotion (yaw and pitch) and grip motion may be similar to thosepreviously described. In this embodiment, one of the instrument couplingdiscs is a shifter input disc and another instrument coupling disc is adrive output control disc. The shifter disc is used to select betweenthree functions of the drive output, namely roll, clamp or fire. Theshifter disc may also be used to lock the drive disc, which may lock theconfiguration of the drive disc during the instrument installation. Inthis embodiment, the shifter disc engagement procedure is performedprior to the drive disc engagement procedure. This ensures that theshifter is engaged before engaging the drive disc. With existingsystems, if the shifter is not engaged, the system may proceed withengaging the drive disc. The system would mistakenly believe that a rollhard stop was encountered when, actually, the instrument was justencountering the resistance of the lock. This would cause the rollposition to be registered to the wrong location and cause subsequentnon-intuitive motion.

At a process 301, multiple ISA discs are rotated in a first rotationaldirection. In this embodiment, the ISA discs rotated at process 301 maybe the discs associated with the control of wrist movement (i.e., yaw,pitch), grip motion for the surgical tool, and shifter motion. Inalternative embodiments, rather than performing parallel (i.e.,simultaneous) processes for engagement of the yaw, pitch, grip, andshifter discs, the engagement process for each disc may be performed inserial. If the multiple disc engagement procedures are performed inparallel, the discs may have differing first rotational direction anddiffering second rotational directions and/or may have differing ratesof rotation.

At a process 302, the control system may determine if the bosses for theyaw, pitch, grip, and shifter ISA discs have fully engaged the pocketsof the instrument disc while the ISA discs are moving in the firstrotational direction. More specifically, the control system maydetermine if the actuating elements driving rotation of the ISA discshave experienced a resistance torque (e.g., a stall) due to instrumentdisc encountering a hard stop. Encountering a hard stop is an indicationthat both bosses of each ISA disc have engaged the pockets of theinstrument discs.

The actuators driving the shifter, yaw, pitch and grip ISA discs may bepreprogrammed to rotate the discs for a preprogrammed number ofrotations in the first rotational direction, according to apreprogrammed protocol. However, if hard stops are encountered (i.e.,engagement is determined) prior to the completion of the preprogrammednumber of rotations in the first direction, the preprogrammed rotationin the first direction is aborted and the engagement procedure proceedsto process 310. Terminating the preprogrammed movement upon detection ofengagement, may speed the overall engagement process.

At a process 304, if engagement of one or more of the ISA discs is notdetected, the ISA disc(s) for which engagement is not detected isrotated in a second rotational direction, opposite the first direction.For example, if the first rotational direction is clockwise, the secondrotation direction is counter clockwise. The ISA discs that are detectedto be engaged at process 302 will not be rotated in the secondrotational direction. At a process 306, the control system determines ifthe bosses of the yaw, pitch, grip, and shifter ISA disc have fullyengaged the pockets of the instrument disc while the ISA disc is movingin the second rotational direction. More specifically, the controlsystem may determine if the actuating element driving rotation of theISA discs have experienced a resistance torque (e.g., a stall) due toinstrument disc(s) encountering a hard stop. Encountering a hard stop isan indication that both bosses of the ISA have engaged the pockets ofthe instrument discs.

The actuators driving the yaw, pitch and grip ISA discs may bepreprogrammed to rotate the discs for a preprogrammed number ofrotations in the second rotational direction, according to apreprogrammed protocol. However, if hard stops are encountered (i.e.,engagement is determined) prior to the completion of the preprogrammednumber of rotations in the second direction, the preprogrammed rotationin the second direction is aborted and the engagement procedure proceedsto process 310. Terminating the preprogrammed movement upon detection ofengagement, may speed the overall engagement process.

If the ISA discs have not engaged the instrument disc after rotation inboth the first rotational direction and the second rotational direction,the process 301 may again be initiated. Optionally, at process 308, thecontrol system may count and limit the number of times the processes301-306 may be repeated. After the count reaches the limit, the controlsystem may provide the user an indication of failure to engage. If theuser receives an indication that the instrument has failed to engage,the instrument may be detached from the ISA and reattached to begin theprocess 300 again.

After processes 302 and 306, if engagement is determined, engagement ofone or more of the remaining ISA discs may be initiated. In thisembodiment, the engaged shifter is moved to select the roll mode. At aprocess 310, the roll ISA disc is rotated in a first rotationaldirection.

At a process 312, the control system may determine if the bosses for theroll ISA disc have fully engaged the pockets of the instrument discwhile the ISA disc is moving in the first rotational direction. Morespecifically, the control system may determine if the actuating elementdriving rotation of the ISA disc for roll has experienced a resistancetorque (e.g., a stall) due to instrument disc encountering a hard stop.Encountering a hard stop is an indication that both bosses of the rollISA disc have engaged the pockets of the instrument disc.

The actuators driving the roll ISA disc may be preprogrammed to rotatethe disc for a preprogrammed number of rotations in the first rotationaldirection, according to a preprogrammed protocol. However, if a hardstop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the firstdirection, the preprogrammed rotation in the first direction is abortedand the engagement procedure proceeds to process 320. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

At a process 314, if engagement of the roll ISA discs is not detected,the roll ISA disc is rotated in a second rotational direction, oppositethe first direction. For example, if the first rotational direction isclockwise, the second rotation direction is counter clockwise. At aprocess 316, the control system determines if the bosses of the roll ISAdisc have fully engaged the pockets of the instrument disc while the ISAdisc is moving in the second rotational direction. More specifically,the control system may determine if the actuating element drivingrotation of the ISA disc has experienced a resistance torque (e.g., astall) due to instrument disc encountering a hard stop. Encountering ahard stop is an indication that both bosses of the ISA disc have engagedthe pockets of the instrument disc.

The actuators driving the roll ISA disc may be preprogrammed to rotatethe disc for a preprogrammed number of rotations in the secondrotational direction, according to a preprogrammed protocol. However, ifa hard stop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the seconddirection, the preprogrammed rotation in the second direction is abortedand the engagement procedure proceeds to process 320. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

If the ISA roll disc has not engaged the instrument disc after rotationin both the first rotational direction and the second rotationaldirection, the process 310 may again be initiated. Optionally, aprocess, 318, the control system may count and limit the number of timesthe processes 310-316 may be repeated. After the count reaches thelimit, the control system may provide the user an indication of failureto engage. If the user receives an indication that the instrument hasfailed to engage, the instrument may be detached from the ISA andreattached to begin the process 300 again.

After processes 312 and 316, if engagement is determined, the successfuland complete engagement of the instrument with the ISA may be confirmedand communicated to a user. After a successful engagement is confirmed,the stapler may be moved to an introductory position to begin themedical procedure. Further, the distal end of the instrument may beprevented from moving beyond the end of the cannula until aftersuccessful engagement is determined.

FIG. 7 is a flowchart 400 showing another illustrative method forinstrument engagement. The instrument engagement procedure is initiatedafter the proximal control portion of the instrument is attached to theISA and the ISA discs are placed adjacent to the instrument discs. Inthis embodiment, the instrument to be engaged may be a clip applier. Theclip applier may receive a clip (e.g., a v-shaped piece of metal orpolymer) that fits between jaws of the clip applier. The clip appliersqueezes the clip onto a blood vessel to seal the vessel. The clip mayinclude a latch that holds the clip closed after it is squeezed by theclip applier. If the clip is prematurely squeezed, it can fall out ofthe clip applier and into the patient. Premature squeezing of the clipmay occur if one of the grip discs on the instrument are not fullyengaged before engaging the disc(s) associated with pitch. The movementin the pitch direction may squeeze the jaw into the cannula and deformthe clip. The below described engagement procedure is designed to avoidsqueezing the clip during the engagement process.

At a process 401, a first ISA disc is rotated in a first rotationaldirection. In this embodiment, the first ISA disc may be the discassociated with the control of roll motion for the instrument shaft. Inalternative embodiments, the ISA may be omitted and the carriage drivediscs may directly engage the instrument discs using the describedengagement procedures. During process 401, as the roll ISA disc isrotated in the first rotational direction, the other ISA discs (e.g.,those controlling yaw, pitch, and grip) are unengaged. They may, forexample, be outside the instrument disc range of motion and/or movableto a preparation position outside the instrument disc range of motion.

At a process 402, the control system may determine or sense if thebosses of the roll ISA disc have fully engaged the pockets of theinstrument disc while the ISA disc is moving in the first rotationaldirection. More specifically, the control system may determine if theactuating element driving rotation of the ISA disc has experienced aresistance torque (e.g., a stall) due to the instrument discencountering a hard stop, which is a physical limitation that preventsthe engaged instrument and ISA discs from continued rotation.

The actuator driving the roll ISA disc may be preprogrammed to rotatethe disc for a preprogrammed number of rotations in the first rotationaldirection, according to a preprogrammed protocol. However, if a hardstop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the firstdirection, the preprogrammed rotation in the first direction is abortedand the engagement procedure proceeds to process 410. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

At a process 404, if engagement of the roll ISA disc is not detected,the ISA roll disc is rotated in second rotational direction, oppositethe first direction. For example, if the first rotational direction isclockwise, the second rotation direction is counter clockwise. At aprocess 406, the control system determines if the bosses of the roll ISAdisc have fully engaged the pockets of the instrument disc while the ISAdisc is moving in the second rotational direction. More specifically,the control system may determine if the actuating element drivingrotation of the ISA disc has experienced a resistance torque (e.g., astall) due to instrument disc encountering a hard stop. Encountering ahard stop is an indication that both bosses of the ISA disc have engagedthe pockets of the instrument discs.

The actuator driving the roll ISA disc may be preprogrammed to rotatethe disc for a preprogrammed number of rotations in the secondrotational direction, according to a preprogrammed protocol. However, ifa hard stop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the seconddirection, the preprogrammed rotation in the first direction is abortedand the engagement procedure proceeds to process 410. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

If the ISA roll disc has not engaged the instrument disc after rotationin both the first rotational direction and the second rotationaldirection, the process 401 may again be initiated. Optionally, at aprocess 408, the control system may count and limit the number of timesthe processes 401-406 may be repeated. After the count reaches thelimit, the control system may provide the user an indication of failureto engage. If the user receives an indication that the instrument hasfailed to engage, the instrument may be detached from the ISA andreattached to begin the process 400 again.

After processes 402 and 406, if engagement is determined, engagement ofone or more of the remaining ISA discs may be initiated. In thisembodiment, at a process 410, multiple ISA discs are rotated in a firstrotational direction. In this embodiment, the ISA discs rotated atprocess 210 may be the discs associated with the control of yaw and gripmotions for the instrument wrist and surgical tool. The discs associatedwith yaw and grip, in this and other embodiments, may be coupled in thatseparate discs move each opposable finger member of the grip. When thefinger members are moved in opposite directions gripping and release ofgrip occurs. When the fingers are moved together, the yaw motion occurs.

At a process 412, the control system may determine if the bosses for theyaw and grip ISA discs have fully engaged the pockets of the instrumentdiscs while the ISA discs are moving in the first rotational direction.More specifically, the control system may determine if the actuatingelements driving rotation of the ISA discs for yaw and grip haveexperienced a resistance torque (e.g., a stall) due to instrument discencountering a hard stop. Encountering a hard stop is an indication thatboth bosses of each ISA disc have engaged the pockets of the instrumentdiscs.

The actuators driving the grip and yaw ISA discs may be preprogrammed torotate the disc for a preprogrammed number of rotations in the firstrotational direction, according to a preprogrammed protocol. However, ifa hard stop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the firstdirection, the preprogrammed rotation in the first direction is abortedand the engagement procedure proceeds to process 420. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

At a process 414, if engagement of one or more of the ISA discs is notdetected, the ISA disc(s) for which engagement is not detected isrotated in a second rotational direction, opposite the first direction.For example, if the first rotational direction is clockwise, the secondrotation direction is counter clockwise. The ISA discs that are detectedto be engaged at process 412 will not be rotated in the secondrotational direction. At a process 416, the control system determines ifthe bosses of the yaw and grip ISA discs have fully engaged the pocketsof the instrument discs while the ISA disc is moving in the secondrotational direction. More specifically, the control system maydetermine if the actuating element driving rotation of the ISA disc hasexperienced a resistance torque (e.g., a stall) due to instrument discencountering a hard stop. Encountering a hard stop is an indication thatboth bosses of the ISA have engaged the pockets of the instrument discs.

The actuators driving the grip and yaw ISA discs may be preprogrammed torotate the disc for a preprogrammed number of rotations in the secondrotational direction, according to a preprogrammed protocol. However, ifa hard stop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the seconddirection, the preprogrammed rotation in the second direction is abortedand the engagement procedure proceeds to process 420. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

If the ISA discs have not engaged the instrument disc after rotation inboth the first rotational direction and the second rotational direction,the process 410 may again be initiated. Optionally, the control systemmay count and limit the number of times the processes 410-416 may berepeated. After the count reaches the limit, the control system mayprovide the user an indication of failure to engage. If the userreceives an indication that the instrument has failed to engage, theinstrument may be detached from the ISA and reattached to begin theprocess 400 again.

After processes 412 and 416, if engagement is determined, engagement ofone or more of the remaining ISA discs may be initiated. In thisembodiment, at a process 420, one or more ISA discs for driving pitchmotion are rotated in a first rotational direction.

At a process 422, the control system may determine if the bosses for thepitch ISA disc(s) have fully engaged the pockets of the instrument discwhile the ISA disc is moving in the first rotational direction. Morespecifically, the control system may determine if the actuating elementsdriving rotation of the ISA disc(s) for pitch have experienced aresistance torque (e.g., a stall) due to instrument disc encountering ahard stop. Encountering a hard stop is an indication that both bosses ofeach ISA disc have engaged the pockets of the instrument discs.

The actuator(s) driving the pitch ISA discs may be preprogrammed torotate the disc for a preprogrammed number of rotations in the firstrotational direction, according to a preprogrammed protocol. However, ifa hard stop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the firstdirection, the preprogrammed rotation in the first direction is abortedand the engagement procedure proceeds to process 430. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

At a process 424, if engagement of the pitch ISA disc is not detected,the pitch ISA disc is rotated in a second rotational direction, oppositethe first direction. For example, if the first rotational direction isclockwise, the second rotation direction is counter clockwise. At aprocess 426, the control system determines if the bosses of the pitchISA disc have fully engaged the pockets of the instrument disc while theISA disc is moving in the second rotational direction. Morespecifically, the control system may determine if the actuating elementdriving rotation of the ISA disc has experienced a resistance torque(e.g., a stall) due to instrument disc encountering a hard stop.Encountering a hard stop is an indication that both bosses of the ISAhave engaged the pockets of the instrument disc.

The actuator(s) driving the pitch ISA discs may be preprogrammed torotate the disc for a preprogrammed number of rotations in the secondrotational direction, according to a preprogrammed protocol. However, ifa hard stop is encountered (i.e., engagement is determined) prior to thecompletion of the preprogrammed number of rotations in the seconddirection, the preprogrammed rotation in the first direction is abortedand the engagement procedure proceeds to process 430. Terminating thepreprogrammed movement upon detection of engagement, may speed theoverall engagement process.

If the ISA discs have not engaged the instrument disc after rotation inboth the first rotational direction and the second rotational direction,the process 420 may again be initiated. Optionally, the control systemmay count and limit the number of times the processes 420-426 may berepeated. After the count reaches the limit, the control system mayprovide the user an indication of failure to engage. If the userreceives an indication that the instrument has failed to engage, theinstrument may be detached from the ISA and reattached to begin theprocess 400 again.

After processes 422 and 426, if engagement is determined, the successfuland complete engagement of the instrument with the ISA may be confirmedand communicated to a user. After a successful engagement is confirmed,the clip applier may be moved to an introductory position to begin themedical procedure. Further, the distal end of the instrument may beprevented from moving beyond the end of the cannula until aftersuccessful engagement is determined.

One or more elements in embodiments of the invention may be implementedin software to execute on a processor of a computer system such as acontrol processing system. When implemented in software, the elements ofthe embodiments of the invention are essentially the code segments toperform the necessary tasks. The program or code segments can be storedin a processor readable storage medium or device that may have beendownloaded by way of a computer data signal embodied in a carrier waveover a transmission medium or a communication link. The processorreadable storage device may include any medium that can storeinformation including an optical medium, semiconductor medium, andmagnetic medium. Processor readable storage device examples include anelectronic circuit; a semiconductor device, a semiconductor memorydevice, a read only memory (ROM), a flash memory, an erasableprogrammable read only memory (EPROM); a floppy diskette, a CD-ROM, anoptical disc, a hard disc, or other storage device, the code segmentsmay be downloaded via computer networks such as the Internet, Intranet,etc.

Note that the processes and displays presented may not inherently berelated to any particular computer or other apparatus. Variousgeneral-purpose systems may be used with programs in accordance with theteachings herein, or it may prove convenient to construct a morespecialized apparatus to perform the operations described. The requiredstructure for a variety of these systems will appear as elements in theclaims. In addition, the embodiments of the invention are not describedwith reference to any particular programming language. It will beappreciated that a variety of programming languages may be used toimplement the teachings of the invention as described herein.

While certain exemplary embodiments of the invention have been describedand shown in the accompanying drawings, it is to be understood that suchembodiments are merely illustrative of and not restrictive on the broadinvention, and that the embodiments of the invention not be limited tothe specific constructions and arrangements shown and described, sincevarious other modifications may occur to those ordinarily skilled in theart.

What is claimed is:
 1. A method of engaging an instrument with an instrument manipulator, the method comprising: receiving an indication that a first input coupling of the instrument is positioned adjacent to a first drive output of the manipulator, the first drive output being driven by a first actuating element; in response to receiving the indication, rotating the first drive output in a first rotational direction; determining, by one or more processors, whether a first resistance torque is experienced by the first actuating element after rotating the first drive output in the first rotational direction; rotating the first drive output in a second rotational direction on the condition that the first resistance torque is not experienced by the first actuating element after rotating the first drive output in the first rotational direction; and determining, by the one or more processors, whether a second resistance torque is experienced by the first actuating element after rotating the first drive output in the second rotational direction.
 2. The method of claim 1 further comprising: repeating the rotating of the first drive output in the first rotational direction on the condition that the second resistance torque is not experienced by the first actuating element after rotating the first drive output in the second rotational direction; and determining, by the one or more processors, whether the first resistance torque is experienced by the first actuating element after repeating the rotating of the first drive output in the first rotational direction.
 3. The method of claim 1 further comprising: receiving a second indication that a second input coupling of the instrument is positioned adjacent to a second drive output of the manipulator, the second drive output being driven by a second actuating element; in response to receiving the second indication, rotating the second drive output in the first rotational direction on the condition that: the first resistance torque is experienced by the first actuating element after rotating the first drive output in the first rotational direction or the second resistance torque is experienced by the first actuating element after rotating the first drive output in the second rotational direction; and determining, by the one or more processors, whether a third resistance torque is experienced by the second actuating element after rotating the second drive output in the first rotational direction.
 4. The method of claim 3 further comprising: rotating the second drive output in the second rotational direction on the condition that the third resistance torque is not experienced by the second actuating element after rotating the second drive output in the first rotational direction; and determining, by the one or more processors, whether a fourth resistance torque is experienced by the second actuating element after rotating the second drive output in the second rotational direction.
 5. The method of claim 3 wherein the instrument includes an elongated shaft and a wrist joint and wherein the first input coupling is configured to drive rotation of the elongated shaft and the second input coupling is configured to drive movement of the wrist joint or rotation of the elongated shaft.
 6. The method of claim 1 wherein the instrument includes a shifter for selecting a stapling function and wherein the first input coupling is configured to drive movement of the shifter.
 7. The method of claim 1 wherein the first resistance torque or the second resistance torque is experienced by the first actuating element after a projection or a pocket of the first input coupling is physically seated with a respective pocket or projection of the first drive output.
 8. The method of claim 1 wherein rotating the first drive output in the first rotational direction includes rotating the first drive output by greater than 360° in the first rotational direction.
 9. A computer-assisted device comprising: one or more processors; and an instrument manipulator configured to receive an instrument; wherein the one or more processors is configured to cause engagement of the instrument with the instrument manipulator by: receiving an indication that a first input coupling of the instrument is positioned adjacent to a first drive output of the manipulator, the first drive output configured to be driven by a first actuating element; in response to receiving the indication, rotating the first drive output in a first rotational direction; determining whether a first resistance torque is experienced by the first actuating element in response to rotating the first drive output in the first rotational direction; rotating the first drive output in a second rotational direction if the first resistance torque is not experienced by the first actuating element in response to rotating the first drive output in the first rotational direction; and determining whether a second resistance torque is experienced by the first actuating element in response to rotating the first drive output in the second rotational direction.
 10. The computer-assisted device of claim 9 wherein the one or more processors is further configured to cause engagement of the instrument with the instrument manipulator by: again rotating the first drive output in the first rotational direction if the second resistance torque is not experienced by the first actuating element in response to after rotating the first drive output in the second rotational direction; and determining whether the first resistance torque is experienced by the first actuating element in response to again rotating the first drive output in the first rotational direction.
 11. The computer-assisted device of claim 9 wherein the one or more processors is further configured to cause engagement of the instrument with the instrument manipulator by: receiving a second indication that a second input coupling of the instrument is positioned adjacent to a second drive output of the manipulator, the second drive output configured to be driven by a second actuating element; in response to receiving the second indication, rotating the second drive output in the first rotational direction if: the first resistance torque is experienced by the first actuating element in response to rotating the first drive output in the first rotational direction or the second resistance torque is experienced by the first actuating element in response to rotating the first drive output in the second rotational direction; and determining whether a third resistance torque is experienced by the second actuating element in response to rotating the second drive output in the first rotational direction.
 12. The computer-assisted device of claim 11 wherein the one or more processors is further configured to cause engagement of the instrument with the instrument manipulator by: rotating the second drive output in the second rotational direction if the third resistance torque is not experienced by the second actuating element in response to rotating the second drive output in the first rotational direction; and determining whether a fourth resistance torque is experienced by the second actuating element in response to rotating the second drive output in the second rotational direction.
 13. The computer-assisted device of claim 9 wherein the instrument includes an elongated shaft and a wrist joint and wherein the first input coupling is configured to drive rotation of the elongated shaft and the second input coupling is configured to drive movement of the wrist joint.
 14. The computer-assisted device of claim 9 wherein the instrument includes an elongated shaft and a wrist joint and wherein the first input coupling is configured to drive movement of the wrist joint and the second input coupling is configured to drive rotation of the elongated shaft.
 15. The computer-assisted device of claim 9 wherein the instrument includes a shifter for selecting a stapling function and wherein the first input coupling is configured to drive movement of the shifter.
 16. The computer-assisted device of claim 9 wherein one of the first input coupling or the first drive output includes a plurality of projections, and wherein the other of the first input coupling or the first drive output includes a plurality of pockets sized to receive the plurality of projections.
 17. The computer-assisted device of claim 16 wherein the first resistance torque or the second resistance torque is experienced by the first actuating element after each projection of the plurality of projections is seated in a respective pocket of the plurality of pockets.
 18. The computer-assisted device of claim 9 wherein the first drive output is a component of an adaptor and is coupled to a carriage portion of the instrument manipulator.
 19. The computer-assisted device of claim 9 wherein rotating the first drive output in the first rotational direction includes rotating the first drive output greater than 360° in the first rotational direction.
 20. A non-transitory machine-readable medium comprising a plurality of machine-readable instructions which when executed by one or more processors associated with a computer-assisted medical device are adapted to cause the one or more processors to perform a method comprising: rotating, in a first rotational direction, a first drive output of a manipulator portion of the computer-assisted medical device, the first drive output driven by a first actuating element; determining whether a first resistance torque is experienced by the first actuating element after beginning the rotating the first drive output in the first rotational direction; rotating the first drive output in a second rotational direction on the condition that the first resistance torque is not experienced by the first actuating element after beginning the rotating the first drive output in the first rotational direction; and determining whether a second resistance torque is experienced by the first actuating element after beginning the rotating the first drive output in the second rotational direction.
 21. The non-transitory machine-readable medium of claim 20 wherein the plurality of machine-readable instructions are adapted to cause the one or more processors to perform the method further comprising: again rotating the first drive output in the first rotational direction if the second resistance torque is not experienced by the first actuating element after beginning the rotating the first drive output in the second rotational direction; and determining whether the first resistance torque is experienced by the first actuating element after again rotating the first drive output in the first rotational direction.
 22. The non-transitory machine-readable medium of claim 20 wherein the plurality of machine-readable instructions are adapted to cause the one or more processors to perform the method further comprising: rotating, in the first rotational direction, a second drive output of the manipulator portion of the computer-assisted medical device, if the first resistance torque is experienced by the first actuating element after rotating the first drive output in the first rotational direction or the second resistance torque is experienced by the first actuating element after rotating the first drive output in the second rotational direction, wherein the second drive output is driven by a second actuating element; and determining whether a third resistance torque is experienced by the second actuating element after beginning the rotating the second drive output in the first rotational direction. 